SERIAL TRICHOTOMIZATION TO IDENTIFY UNSAFE DRIVERS: UPDATE FROM A PROSPECTIVE STUDY

Abstract Identifying older adults who may be unsafe to drive remains a difficult task. Gibbons et al. (2017, American Journal of Occupational Therapy) used serial trichotomization based on five cognitive tests to determine if drivers should: 1) continue driving, 2) undergo further evaluation, or 3) stop driving. The tests included the Trail-making-tests A and B (TMT-A/B), the clock-drawing test (CDT), the Motor-Free Visual Perception Test (MVPT), and the Montreal Cognitive Assessment (MoCA). Gibbons et al. relied on dual cut-off values to achieve 100% sensitivity and specificity (within their sample) to reduce false positives and false negatives that arise from using these tests in stand-alone fashion. We used the Gibbons et al. cut-off values prospectively on a cohort of 293 drivers (mean age = 66, SD = 14) referred for driving evaluations at a chronic care and rehabilitation hospital. Each driver completed the five tests. Trained occupational therapists (OTs) provided a recommendation to continue driving, undergo further evaluation, or stop driving. We examined congruence between the tests and the OTs recommendations. Weighted Kappas ranged from a low of .03 (95% CI = -.01 to .08) for the CDT, to a high of .53 (95% CI = .45 to .61) for the TMT-B. Using the same cut-offs, and serial trichotomization, the congruence with the final recommendations was moderate (k = .57, 95% CI = .49 to .66). These results remind us of the variability inherent in stand-alone cognitive tests and even within a serial trichotomization framework.

States, 4. University of Victoria, Victoria, British Columbia, Canada The potential for assistive robots to support older adults' independence and social connections requires careful consideration of their implications in everyday use.This study investigates the use of two assistive robots, Labrador and Double, in older adults, guided by Actor-Network Theory (ANT).Labrador (a delivery robot) assists with medication management, meals, laundry, house cleaning to support independence, while Double (a teleprence robot) enables virtual social visits.ANT offers a way to understand how the robots interact with different actors, such as older adults, family members, staff, and the environment in which they operate.We applied a qualitative approach to explore how users construct meanings, use, and make sense of the robots in their everyday contexts.Semi-structured interviews and ethnographic fieldwork were conducted with participants to generate data.Reflexive thematic analysis was performed, and three themes emerged: (1) the human-robot relationship, (2) the robot's agency, and (3) ethical implications.The findings suggest that having the robots in everyday life is a process of constant negotiation with the people, practice, and the robot.The study highlights the challenges and opportunities associated with the implementation of robots to improve quality of life in senior care.While there is a fear that assistive robots will dehumanize caring practices, our study shows that they have the potential to foster innovative user-technology relationships, which requires further research.
Abstract citation ID: igad104.1354Driving retirement can be a disruptive decision for people with Alzheimer's disease and related dementias (AD/ADRD) and their families.Retiring drivers with AD/ADRD may lose their sense of independence and connection to community.Family members can experience relationship stress convincing persons with dementia to stop driving and feel strained taking on transportation responsibilities.CarFreeMe™-Dementia (CFM™-D) is an individualized psychosocial driving retirement program for families who are planning for, implementing, or adjusting to driving retirement.A small feasibility study of the program in the U.S. indicated that participants found it acceptable and useful for navigating driving retirement.Phase 2 of this study, enrolling 17 care partners, 16 retiring drivers, and 17 dyads, evaluated the preliminary efficacy of CFM™-D to provide emotional support and increase driving retirement readiness.Data from baseline, 3-, and 6-month surveys and an exit semistructured interview were collected.Interviews confirmed that CFM™-D provided emotional support and practical preparation for driving retirement.Chi-square analyses comparing baseline to 6-month follow-up data showed fewer caregivers reached thresholds for concern on scales of strain (p = .019)and isolation (p = .001).Retiring drivers reported reductions in loneliness at 6-months (p = .017)and improved Assessment of Readiness for Mobility Transition scores at 3-and 6-month follow-ups (p = .003,p = .014,respectively).Findings have informed intervention delivery improvements for a future randomized trial evaluating whether CFM™-D is an efficacious tool for addressing the psychosocial complexities of driving retirement amongst people with AD/ ADRD and their family.

PRELIMINARY EFFICACY OF CARFREEME™-DEMENTIA: A DRIVING RETIREMENT PROGRAM FOR FAMILIES IN THE US
Abstract citation ID: igad104.1355

SERIAL TRICHOTOMIZATION TO IDENTIFY UNSAFE DRIVERS: UPDATE FROM A PROSPECTIVE STUDY
Michel Bedard 1 , Sacha Dubois 2 , Hillary Maxwell 2 , Stephanie Schurr 3 , Bruce Weaver 1 , and Arne Stinchcombe 4 , 1. Lakehead University,Thunder Bay,Ontario,Canada,2. St. Joseph's Care Group,Thunder Bay,Ontario,Canada,3. St. Joseph's Care Group,Thunder Bay,Ontario,Canada,4. University of Ottawa,Ottawa,Ontario,Canada Identifying older adults who may be unsafe to drive remains a difficult task.Gibbons et al. (2017, American Journal of Occupational Therapy) used serial trichotomization based on five cognitive tests to determine if drivers should: 1) continue driving, 2) undergo further evaluation, or 3) stop driving.The tests included the Trail-making-tests A and B (TMT-A/B), the clock-drawing test (CDT), the Motor-Free Visual Perception Test (MVPT), and the Montreal Cognitive Assessment (MoCA).Gibbons et al. relied on dual cut-off values to achieve 100% sensitivity and specificity (within their sample) to reduce false positives and false negatives that arise from using these tests in stand-alone fashion.We used the Gibbons et al. cut-off values prospectively on a cohort of 293 drivers (mean age = 66, SD = 14) referred for driving evaluations at a chronic care and rehabilitation hospital.Each driver completed the five tests.Trained occupational therapists (OTs) provided a recommendation to continue driving, undergo further evaluation, or stop driving.We examined congruence between the tests and the OTs recommendations.Weighted Kappas ranged from a low of .03(95% CI = -.01 to .08) for the CDT, to a high of .53(95% CI = .45to .61) for the TMT-B.Using the same cut-offs, and serial trichotomization, the congruence with the final recommendations was moderate (k = .57,95% CI = .49to .66).These results remind us of the variability inherent in standalone cognitive tests and even within a serial trichotomization framework.

SESSION 3575 (AWARD LECTURE)
Chair: Steven Austad The Irving S. Wright Award of Distinction Lecture will feature an address by the 2023 recipient Rafael De Cabo, BS, FGSA of National Institute on Aging, National Institutes of Health.The Vincent Cristofalo Rising Star Award in Aging Research lecture will feature an address by the 2023 Colleen Peterson 1 , Stephanie N. Ingvalson 2 , Robyn Birkeland 2 , Katie Louwagie 2 , Maya Koffski 2 , and Joseph Gaugler 2 , 1. University of Michigan, Ann Arbor, Michigan, United States, 2. University of Minnesota, Minneapolis, Minnesota, United States